MICRA, the 1975 California law that caps noneconomic damage awards at $250,000 for patients injured or killed by negligent medical care, is actually increasing, not decreasing as intended, health care costs in our state.

Preventable medical errors claim are up to 440,000 lives each year, according to a recent study in the Journal of Patient Safety, making it the third leading cause of death in the nation.

University of Pennsylvania law professor Tom Baker says there is an epidemic of medical malpractice, not malpractice lawsuits.

Why do we care? Last year, our 21-month-old daughter, Morgan, died when physicians failed to rescue her from known complications after a matrix of errors they made during surgery to correct a congenital heart defect. She was mortally wounded in her femoral artery, resulting in massive blood loss, cardiac arrest and culminating in brain death.

Morgan had a full life ahead of her: To grow and share years with her identical twin sister, Hunter, who had the same medical procedure, with the same physicians, at the same hospital.

Hunter is alive and well with us today.

The key to lower health care cost is patient safety. Patient safety is improved by extreme transparency: The free, uninhibited sharing of information to improve care. This includes disclosing all medical errors.

For a compelling example of how extreme transparency is the cornerstone of safety, look no further than the work of the Federal Aviation Administration. If a battery proves faulty in a Boeing 787 in Dallas, the sun will not set before mechanics know about it from Guam to Maine.

Extreme transparency in commercial aviation has resulted in costs per mile flown plummeting by 50 percent over the last 30 years (inflation adjusted).

Think about it: Would our aviation industry be where it is today if it was killing 440,000 people a year?

MICRA, the Sacramento political shorthand for the Medical Injury Compensation Reform Act of 1975, presents monumental roadblocks to accessing the justice system and seeking accountability after fatal medical mistakes take a loved one. Errors that would be uncovered through legal discovery instead end up shrouded in secrecy at the morbidity and mortality meeting rooms of hospitals. Other times, the mistakes end up buried with the victim.

This lack of transparency ensures that the same mistakes will continue to be made over and over again, driving up costs and reducing access to the health care system for all.

Until the medical industry’s cultural barriers toward transparency dissolve and preventable medical errors are reduced, access to the justice system offers the only real mechanism to bring extreme transparency, helping reduce costs by preventing errors in the first place.

This is an important issue to anyone who might find a loved one in a hospital, which means just about all of us at one time or another. In the state Capitol, State Senate President Pro Tem Darrell Steinberg, D-Sacramento, recently introduced legislation, SB1429, seeking to modernize MICRA’s restrictive cap, which has not been adjusted for inflation since its enactment 38 years ago. If legislative efforts go nowhere in the next few weeks, reform advocates have the signatures to put a patient safety initiative on the November ballot.

The California Medical Association counters that the effort to modernize MICRA is a ploy by “greedy trial lawyers” to make more money. A simple way to eliminate trial attorneys from the equation is for health care providers to eliminate errors. No errors, no lawsuits.

Since this is unrealistic, given that to “err is human,” the next best way to reduce errors is for health care providers to adopt extreme transparency in disclosing, apologizing and reasonably compensating victims who they harm.

Transition can be tough for any industry, but the benefits for medicine are many. Litigation costs will go down, patient safety will go up and clinicians will never again have to defend the indefensible. Doctors can practice medicine from a stewardship approach, not a defensive approach. Look no further than the University of Michigan Health Care model, or Virginia Mason Hospital in Seattle. It can be done, but it takes extreme leadership and transparency to get the job accomplished.